WAUSAU – The number of Hmong adults who smoke has plunged in the last dozen years, and leaders say it's due in part to a cultural effort to spread an anti-tobacco message.

Only about six out of 100 Hmong adults in Wisconsin smoke, according to the latest Hmong Annual Tobacco Surveillance Project. That's a significant drop from the first survey done in 2002, when 20 percent of Hmong adults said they smoked. It's also much lower than the national rate for all Americans, which in 2013 was nearly 18 of every 100 adults, according to the nation's Centers for Disease Control.

The tobacco-use study has been organized through the Wisconsin United Coalition of Mutual Assistance Association, and done with financial backing from the state Department of Health Services.

"It's good news for us," said Thai Vue, the executive director of the Wisconsin United Coalition of Mutual Assistance Associations and the study's project supervisor. "One of the questions we asked when seeing these results is, 'How is this possible?'"

Vue and other Hmong leaders, including Peter Yang, executive director of Wausau's Hmong American Center; Lo Neng Kiatoukaysy, executive director of the Hmong American Friendship Association in Milwaukee; and Xai Shoua Chang, who represents the Hmong American Association of Portage County spoke about the survey results on Wednesday at the Hmong American Center in Wausau.

They all said three main factors seem to have had an influence on Hmong smoking habits.

First, when the tobacco surveillance project was kicked off in 2001, their agencies and others across the state also pushed out an aggressive anti-tobacco educational effort.

Second: Clan leaders and other local elders got on board to spread the message about the heavy health risks that come from smoking. In particular, the message was spread to parents, who exerted pressure on their children not to smoke.

And third: Respected elders, many of whom fought in Laos on the side of the United States during the Vietnam War — who often were heavy smokers because cigarettes were free — began to get sick with cancer and other smoking-related illnesses. Watching that, and listening to those leaders, seemed to have squashed smoking tendencies among younger people.

"I think the clan system and the family structure plays a vital role," Vue said.

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(Photo: T'xer Zhon Kha/Gannett Wisconsin Media)

Chai Xiong, 34, a volunteer with the Wisconsin United Coalition, offered a little personal insight about how the close-knit, family-oriented culture could have worked to keep smoking rates down.

"When I was 14, I tried smoking. ... Some of my friends were smoking. ... My father found out, and then he told my uncles. And every time I would see one of my uncles, he would say, 'Hey, I heard you are smoking.' I was so ashamed. I never smoked again," Xiong said.

Vue said the good news does not mean that efforts to eliminate tobacco use in Hmong people is over.

"We're going to look at the youth population," Vue said. "The younger people are not as afraid of the health aspects."

Vue said there also needs to be more work done to study the tobacco use habits of Hmong children, including their use of e-cigarettes.

Keith Uhlig can be reached at 715-845-0651 or at kuhlig@gannett.com. Find him on Facebook or on Twitter as @UhligK.